How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $120.23 | Facility | None | $58.88 | $58.88 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $89.13 Typical High $120.23 | Facility | None | $60.26 | $89.13 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $60.26 Typical High $75.86 | Professional | None | $58.88 | $60.26 | $75.86 |
CareSource Setting Facility Modifier None Typical Low $61.66 Median $91.20 Typical High $123.03 | Facility | None | $61.66 | $91.20 | $123.03 |
CareSource Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $144.54 Typical High $162.18 | Facility | None | $79.43 | $144.54 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $93.33 | Professional | None | $58.88 | $58.88 | $93.33 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $117.49 Median $125.89 Typical High $190.55 | Facility | None | $117.49 | $125.89 | $190.55 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $112.20 | Professional | None | $56.23 | $75.86 | $112.20 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $75.86 | Professional | None | $60.26 | $60.26 | $75.86 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $28.84 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.71 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $5.89 |
Where Indiana sits
Rates are fairly even across states for this service. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 50th of 51
$58.88
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.